Kane et al developed a simple score for identifying patients who may have microscopic colitis. This can help to identify a group of patients who may benefit from a diagnostic workup. The authors are from St. James's University Hospital in Leeds and the University of Leeds.
Patient selection: possible microscopic colitis
Parameters:
(1) gender
(2) age in years
(3) proton pump inhibitor (PPI) therapy
(4) NSAID therapy
(5) weight loss
(6) abdominal pain
Parameter |
Finding |
Points |
gender |
male |
0 |
|
female |
4 |
age in years |
< 50 years |
0 |
|
>= 50 years |
13 |
PPI therapy |
no |
0 |
|
yes |
6 |
NSAID therapy |
no |
0 |
|
yes |
11 |
weight loss |
no |
0 |
|
yes |
4 |
abdominal pain |
no |
0 |
|
yes |
-8 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: -8
• maximum score: 38
• The higher the score the greater the risk of the patient having microscopic colitis.
• A score >= 4 is sensitive (95-99%) but not very specific (33-37%). The goal with this score is not to miss any cases. A score < 4 had a 97-99% negative predictive value.
• A score >= 8 was 90-94% sensitive and 45-49% specific.
Performance:
• The area under the ROC curve was 0.76.
Specialty: Gastroenterology